DrugBuyers
Administrator
Reged: 11/18/01
Posts: 1234
Loc: DrugBuyers.Com
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Association of American Physicians and Surgeons, Inc
 
Quote:
ADVICE TO DOCTORS RE: PAIN MANAGEMENT
(or "What the government has taught doctors.")
Until wrongs are righted and procedural changes are made, physicians have little choice other than to be unusually suspicious of new patients, to require unnecessary and expensive tests, to waste time on excessive documentation, or to turn away suffering patients, even if they think the patients may not find anyone else to treat them.
If you're thinking about getting into pain management using opioids as appropriate:
DON'T. Forget what you learned in medical school -- drug agents now set medical standards.
If you do, first discuss the risks with your family.
They could lose a mother or father or breadwinner, their home, their car, their college fund;
There could be years of harassment and legal fees;
Your colleagues will probably ostracize you and family members at the first sign of trouble.
If you are already prescribing opioids:
Beware of new patients. If you accept a new patient, do background checks, demand old records before writing the first Rx, obtain urine screens and get them to sign opioid contracts. It is safer to turn them down, explain why, and give them an action item (call their congressman, for example).
Do thorough physicals, even if unnecessary and not helpful.
Make voluminous notes.
Exercise zero tolerance for patient slip-ups (such as losing a prescription).
Beware of any patients with a history of drug abuse. Even if now clean and in genuine pain, they might be induced by government zealots to testify against you to save themselves from imprisonment on drug charges.
Refer patients early and often to addictionologists, orthopedists, pain specialists, psychologists, regardless of expense or your opinion of helpfulness.
Keep a low profile and beware of saying anything that might offend an official of law enforcement, the licensure board, or the state medical society.
Never forget that you could be held to a standard of strict liability for any patient misbehavior or for any bad outcomes such as death, no matter the cause and without regard to the culpability of the patient or his associates. Remember, your medical decisions will be reviewed by drug agents who will decide if your actions were medically reasonable.
Consider phasing out this part of your practice, giving patients plenty of time to find another doctor.
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The best and fastest way to get help is at: https://drugbuyers.com/help
Please do not PM me about non working or lost usernames and passwords.
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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When I looked at the AAPS website, that put the above article into perspective. I don't believe they really want to advocate the "advice" above, I believe it is a semi-satire piece in response to the "war on pain doctors" articles from the same website and perhaps even a survival manual to doctors. It is really sad that law enforcement officials and insurance companies can tell doctors (who have attended many years of graduate school and OTJ training) what is medically necassary Anybody ever seeen "JOHN Q" --don't be surprised if this happens more often--and not just for transplant patients.
Doctors say US Drug policy forces pain patients to extreme measures, turns doctors into criminals
Administration declares war on doctors; vows to treat like Taliban
US DEPARTMENT OF JUSTICE ARRESTS ESTEEMED PAIN PHYSICIAN DR. WILLIAM HURWITZ PART OF A DISTURBING NATIONAL TREND MEDICAL EXPERTS AND NATIONAL PAIN CARE ADVOCATES SPEAKING OUT
et. al.
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Never underestimate the predictability of stupidity.
Edited by night_shade (11/27/03 09:47 AM)
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Ocean
Member
Reged: 04/20/03
Posts: 137
Loc: Outside of New York City
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Quote:
Administration declares war on doctors; vows to treat like Taliban
What??? WTF??? OK, this is very serious... Ashcroft is running wild like a madman and no one but a small number of organizations are giving a second thought to this issue... No one in a position to change anything anyway...
If this administration gets another four years we are all completely screwed... They will put the OPs out of business very soon, eliminating that option for us, and then will intensify their campaign against local doctors so we won't be able to get a Doctor to prescribe a Tylonol 3 unless we're dying... And even then they'll want to confirm you're not an addict... Just in case you're faking dying...
This has really got me scared... My mission from this moment forward is to get Bush out of the Whitehouse in 04... I believe my life depends on it...
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Such a long, long time to be gone... And a short time to be there...
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Opie_Yates
Old Hand
Reged: 08/11/03
Posts: 478
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Quote:
Quote:
Administration declares war on doctors; vows to treat like Taliban
What??? WTF??? OK, this is very serious... Ashcroft is running wild like a madman and no one but a small number of organizations are giving a second thought to this issue... No one in a position to change anything anyway...
If this administration gets another four years we are all completely screwed... They will put the OPs out of business very soon, eliminating that option for us, and then will intensify their campaign against local doctors so we won't be able to get a Doctor to prescribe a Tylonol 3 unless we're dying... And even then they'll want to confirm you're not an addict... Just in case you're faking dying...
This has really got me scared... My mission from this moment forward is to get Bush out of the Whitehouse in 04... I believe my life depends on it...
Oh puhleeze...Bush this, Bush that, blame all my problems on Bush, wah wah wah....I guarantee you, this crosses party lines and would have been the same with Gore.
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I'm not a doctor, I just play one on a message forum!
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sheenafur
Enthusiast
Reged: 04/25/03
Posts: 225
Loc: California
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Opie Yates,
Everything that runs through your mind doesn't need to be written and posted on the board. If you love Bush and Ashcroft so much, why don't you write an intelligent post about why. Why don't you explain to us why voting for Bush is a good idea. I don't see any place where the poster blames all their problems on Bush. And who mentioned Gore?
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Go easy, step lightly, stay free--J. Strummer
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Ocean
Member
Reged: 04/20/03
Posts: 137
Loc: Outside of New York City
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Please take a good hard look at both of our posts...
Instead of giving me one single argument as to why I'm wrong, which I would have really liked, you went for the personal attack... It's that exact approach that widens the gap between Libs and Cons... Can't we ever just discuss issues like grown adults without insult-throwing and name-calling? We have a very serious problem on our hands! Unless we stand TOGETHER and try to fight this, we are all doomed!!!
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Such a long, long time to be gone... And a short time to be there...
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borrowedtime
Journeyman
Reged: 08/27/03
Posts: 95
Loc: Continental Divide, USA
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Very well said Ocean. Positive, effective, open communication is key to any conflict resolution. Is this even possible??? Wish I knew...Just wanted to throw in my two cents in specific regards to the gap between "sides." One thing is certain, at the end of the day, somebody is to be held accountable for such issues!! That is the problem imo, nobody accepts responsibility...always somebody else's problem. Take care.
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Opie_Yates
Old Hand
Reged: 08/11/03
Posts: 478
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Well, just let me echo Ocean's opinion without having to give backup or explanation why, and maybe taking a little liberty with context along the way...it would be the same thing. By the way...I don't like Ashcroft but I don't think he is any better or worse than was Reno. I am a Libertarian, not a Republican, but given the lack of organization by the Libertarian party, Republicans are by far the better choice.
Ocean, I wasn't attacking you, I was attacking the mentality you perpetuate. The government can't make your life better, but it sure the heck can make it worse...that is why it is my mission is to keep Bush in the White House during the 2004 election. Any of the current potential Democratic candidates would drive this country into ruin, and I guarantee you that they could give less of a Best if kept off the board about your pain than anyone else. All they want is power at your expense, and mine. Why are they panicking now? Because the economy is improving, investments are doing better, and people are going back to work. That is why they pimp the poor, the elderly, and minorities. They've not done one iota to further the cause of any class of these individuals, and have only made their lot in life worse AND more dependent on the government teat.
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I'm not a doctor, I just play one on a message forum!
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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It is a personal thing I have against getting into political discussions, so I won't touch that.
I do think, though, that the doctor-patient relationship should be absolutely sacred. It is disgusting that there even needs to be this semi-satire (as night_shade put it). What a sad world we live in when bureaucrats hungry for votes (from a public who doesn't understand) will drive a chronic pain patient to suicide because the drugs they need to live a decent life could be used by someone else to get high (God forbid anyone gets high).
I just wish there was something more we could do other than write letters to public officials. I would gladly donate and/or volunteer whatever I could to any organization that was actively making a difference...does anyone here have one they donate to and would recommend?
-yawkaw
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 884
Loc: usa
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Really....I've been to Washington...by 9PM THEIR ALL HIGH, on the last legal bastion of HIGHDOM...alcohol! I say, I'll let you take my freaking oxycontin when I pry that Higball out of your cold dead hands!!!!!!
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Hertz50
Journeyman
Reged: 04/02/03
Posts: 75
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Too funny ..........but unfortunately true!!!!
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actonbell
Journeyman
Reged: 09/08/03
Posts: 82
Loc: Oklahoma
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Lmao...As far as the drug thing goes, it is that stubborn streak of puritanism knocking around in America that keeps us from having sensible drug laws, not who is in office. As long as you have people like my mother, god love her, who thinks that addiction is the same as worshiping satan (and this woman is a nurse,by the way) whatever political group that is in office will continue this "drug war" until pain patients and doctors get to be a big enough and vocal enough voting bloc. It is the large squeaky wheels that get greased. I would suggest that places like American Pain Association are doing a good job changing minds, but it is slow going. I have ordered their pamphlets and handed them out to nurses from different clinics and gave one to my hidebound mommy. The real clincher is if one of the large religious organizations would get behind changes in the drug laws. My goodness if they can promote a gay Bishop, the least they could do is back doctors and pain patients. I would ask my church but I don't believe in 'em, churches that is. No offense to the devout here on the board.
I am a democrat who thinks about half of the libertarian platform should be adopted. Specifically the half that deals with government interference in the lives of citizens. That is not governments job.
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All it takes to fly is to hurl yourself at the ground....and miss.
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2muchpain
Enthusiast
Reged: 10/07/03
Posts: 274
Loc: USA
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SO very true. Most of these folks are very heavy drinkers and don't see any connection whatsoever between their 'socializing' and our pain management. I think quite of few of them self-medicate with alcohol and everyone else looks the other way. They get stopped for a DUI and a sympathetic cop drives them home. It makes me sick but that's the way it is.
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moonbeam
Member
Reged: 05/23/03
Posts: 180
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actonbell for president and Ocean for vice president! You have my vote.
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EMJ
Old Hand
Reged: 12/20/01
Posts: 471
Loc: Southeast US
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I lived in DC for a while, and you hit the nail on the head. I have seen it for myself. IMSUSCOTI, I agree with you, I want to see all of these "higher ups" stop the drinking (and then driving), they don't see anything wrong with their actions, until they run over someone or kill an innocent bystander because they think they are above the law. And, at times it does seem that way. Wish I had the answers. EMJ
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I'm on the move to get past "Old Hand"
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polo
Stranger
Reged: 04/15/04
Posts: 11
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i have expereinced this first hand, as many of you guys have too, when a doctor is cross examining you when you need pain meds. i know there are many other issues involved when it comes to precribing narcotic meds, but when im in pain, i dont care if my dog ate my precription. i need another PRESCRIPTION. where do these guys come off thinking they can regulate my pain or well being.....i know my bitc*ing wont help much, but i thought i might vent with yall
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fxrguy
Banned: posting about recreational drug use.
Reged: 02/10/04
Posts: 10
Loc: frisco, calif..
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hey all, its a sad day when the dam feds bring our care givers down to the level of looking over there shoulders at every turn. sweeping there offices for bugs.. i am very glade that i have found 2 doctors that will work with me.
man i can't belive the prices of oxy's. if i had to pay for them my wife would have to get a second job, LOL
any why some of the doctors need to grow some b*lls...
i know of 1 that has and now has lost his class 2 rights to care for those in pain... oh well
god bless, live pain free, fxr
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Dyno
Journeyman
Reged: 03/23/04
Posts: 89
Loc: Washington
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I knew they were teaching stupid
in med school I just didn't know
how stupid they really could be
I hope they wise up soon or we
are all doomed to live with pain 
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Wishing all pain free days D.
Edited by Dyno (05/10/04 10:06 PM)
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